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BILMNG ADDRESS
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r_-AN # ORDER #
CONTACT NAME ~)~YL I~ /1~ J'SJf 0 I
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iNVOiCE TO ATrN OF
EQUIPMENT LOCATION (IF NOT SAME AS ABOVE)
CITY
STATE
~PD~E
NAME ON CARD
TYPE
TAX EXEMPT #
RSCAL PERIOD FROM TO
C~ Yenr _R,e_in_~_$ Needs
APPROVED, AS TO
FORM BY: ~R~
Payment Schedule / Billing e Rental Terms and Cenditlens
~ Your Pa~_nt Plan
initial Rental Term:
Frequency [] Monthly [] Quarterly [] Other (sp tiff__
IniUalCheckAmount $ /.~'~ ' ~
PRINT NAME
employee sign it. NI payments hereunder shall be payable only to us at our exEcuUve offices unLeSS we direct you
otherwise in w~ng.
TITLE
DATE
PB ACCOUNT REP NAME
PB ACC~ ~*-u BY
EMPLOYEE # 7 P 9 -~ ~-P
TITLE
DATE
EXECUTIVE OFFICE: 27 WATERVIEW DR * SHELTON, CT 06484-4361 · EQUIPMENT VENDOR: PITNEY BOWES, INC. · FOR SALES AND SERV1CE CALL 1-800-322-8000
WHITE COPY PBCC · PINK COPY PITNEY BOWES INC. · YELLOW COPY CUSTOMER
PAGE 1
PB SLR2 (8/01) SEE PAGE 2 FOR ADDITIONAL TERMS AND CONDITIONS ~
Approved and Adopted this ? day of~f
CITY OF CARMEL, INDIANA
by and through its Board of Public
Works and Safety
BY:
Ja~es Brainard, May
Date: o~' $ ~ OJ
M~ urke Member
Date: ~1~
ATTEST:
iana Cordray, Clerk-~reasurer
Date: °2/'~/0~
Depu~ Clerk for
)enefits such as. · ·
·.. Non-Appropriation
~stomized Billing
~rchase Order Acceptance
mplified Documentation
· edit Card Acceptance
~stomer Satisfaction Guarantee
much more!
-.ontact us if you have any questions or comments.
~ipment Sales, Service and installation .......... 1-800-322-8000
;ey Bowes Inc.
te and Local Government Term Rental Agreement
:tare and Local Government Agency:
are not permitted to sign the Pitney Bowes Inc, State and Local Government Term Rental Agreement,
~stead must issue a purchase order to Pitney Bowes Inc. in order to rent the equipment under this
=,ment, the following language must appear in the body of your purchase order:
Agency is obtaining the equipment as described in the Pitney Bowes Inc. State and Local Government
Rental Agreement #PB SLR2 (8/0t), and the terms and conditions of the Agreement shall govern this